Members who use our standard formulary typically have a tiered benefit structure as part of their prescription plan. Check benefits and eligiblity to determine the member's benefit structure and out-of-pocket cost. Below, you can either view covered medications by the member's tier design or by using the standard formulary look-up tool.

List of medications covered by the member's plan (standard formulary)

Choose the member's tier design to see a list of medications their plan covers.

Standard formulary look-up tool
You can also use our search feature to look-up coverage for a medication.

FIXME: SearchPharmacyPortlet

Drug:

Strength:

Dosage Form:

Prior Authorization:

Quality Care Dosing (QCD):(Maximum Quantity per Rx)

Tier:

Notes:

Select a tier structure

Tier structure:

4-tier3-tier2-tier

Enter medication name (minimum 3 letters)

Medication name:

Sorry. No matches were found.

Medication

Tier (copay level)

Covered alternative

Prior authorization

Quality care dosing

Select a drug group and drug sub-group (if applicable) from the list and click Search.

Just so you know....
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